Brief Report: Malignancies in Adults Living With HIV in Asia
BACKGROUND: Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia. METHODS: Incidence of malignancy after cohort...
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th-cmuir.6653943832-637012019-03-18T02:24:22Z Brief Report: Malignancies in Adults Living With HIV in Asia Awachana Jiamsakul Mark Polizzotto Stephane Wen-Wei Ku Junko Tanuma Eugenie Hui Romanee Chaiwarith Sasisopin Kiertiburanakul Anchalee Avihingasanon Evy Yunihastuti Nagalingeswaran Kumarasamy Penh Sun Ly Sanjay Pujari Rossana Ditangco Cuong Duy Do Tuti Parwati Merati Pacharee Kantipong Fujie Zhang Kinh Van Nguyen Adeeba Kamarulzaman Jun Yong Choi Benedict L.H. Sim Oon Tek Ng Jeremy Ross Wingwai Wong Medicine BACKGROUND: Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia. METHODS: Incidence of malignancy after cohort enrollment was evaluated. Factors associated with development of hematological and nonhematological malignancy were analyzed using competing risk regression and survival time using Kaplan-Meier. RESULTS: Of 7455 patients, 107 patients (1%) developed a malignancy: 34 (0.5%) hematological [0.08 per 100 person-years (/100PY)] and 73 (1%) nonhematological (0.17/100PY). Of the hematological malignancies, non-Hodgkin lymphoma was predominant (n = 26, 76%): immunoblastic (n = 6, 18%), Burkitt (n = 5, 15%), diffuse large B-cell (n = 5, 15%), and unspecified (n = 10, 30%). Others include central nervous system lymphoma (n = 7, 21%) and myelodysplastic syndrome (n = 1, 3%). Nonhematological malignancies were mostly Kaposi sarcoma (n = 12, 16%) and cervical cancer (n = 10, 14%). Risk factors for hematological malignancy included age >50 vs. ≤30 years [subhazard ratio (SHR) = 6.48, 95% confidence interval (CI): 1.79 to 23.43] and being from a high-income vs. a lower-middle-income country (SHR = 3.97, 95% CI: 1.45 to 10.84). Risk was reduced with CD4 351-500 cells/µL (SHR = 0.20, 95% CI: 0.05 to 0.74) and CD4 >500 cells/µL (SHR = 0.14, 95% CI: 0.04 to 0.78), compared to CD4 ≤200 cells/µL. Similar risk factors were seen for nonhematological malignancy, with prior AIDS diagnosis showing a weak association. Patients diagnosed with a hematological malignancy had shorter survival time compared to patients diagnosed with a nonhematological malignancy. CONCLUSIONS: Nonhematological malignancies were common but non-Hodgkin lymphoma was more predominant in our cohort. PLHIV from high-income countries were more likely to be diagnosed, indicating a potential underdiagnosis of cancer in low-income settings. 2019-03-18T02:24:22Z 2019-03-18T02:24:22Z 2019-03-01 Journal 19447884 2-s2.0-85061481888 10.1097/QAI.0000000000001918 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85061481888&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/63701 |
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Medicine Awachana Jiamsakul Mark Polizzotto Stephane Wen-Wei Ku Junko Tanuma Eugenie Hui Romanee Chaiwarith Sasisopin Kiertiburanakul Anchalee Avihingasanon Evy Yunihastuti Nagalingeswaran Kumarasamy Penh Sun Ly Sanjay Pujari Rossana Ditangco Cuong Duy Do Tuti Parwati Merati Pacharee Kantipong Fujie Zhang Kinh Van Nguyen Adeeba Kamarulzaman Jun Yong Choi Benedict L.H. Sim Oon Tek Ng Jeremy Ross Wingwai Wong Brief Report: Malignancies in Adults Living With HIV in Asia |
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BACKGROUND: Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia. METHODS: Incidence of malignancy after cohort enrollment was evaluated. Factors associated with development of hematological and nonhematological malignancy were analyzed using competing risk regression and survival time using Kaplan-Meier. RESULTS: Of 7455 patients, 107 patients (1%) developed a malignancy: 34 (0.5%) hematological [0.08 per 100 person-years (/100PY)] and 73 (1%) nonhematological (0.17/100PY). Of the hematological malignancies, non-Hodgkin lymphoma was predominant (n = 26, 76%): immunoblastic (n = 6, 18%), Burkitt (n = 5, 15%), diffuse large B-cell (n = 5, 15%), and unspecified (n = 10, 30%). Others include central nervous system lymphoma (n = 7, 21%) and myelodysplastic syndrome (n = 1, 3%). Nonhematological malignancies were mostly Kaposi sarcoma (n = 12, 16%) and cervical cancer (n = 10, 14%). Risk factors for hematological malignancy included age >50 vs. ≤30 years [subhazard ratio (SHR) = 6.48, 95% confidence interval (CI): 1.79 to 23.43] and being from a high-income vs. a lower-middle-income country (SHR = 3.97, 95% CI: 1.45 to 10.84). Risk was reduced with CD4 351-500 cells/µL (SHR = 0.20, 95% CI: 0.05 to 0.74) and CD4 >500 cells/µL (SHR = 0.14, 95% CI: 0.04 to 0.78), compared to CD4 ≤200 cells/µL. Similar risk factors were seen for nonhematological malignancy, with prior AIDS diagnosis showing a weak association. Patients diagnosed with a hematological malignancy had shorter survival time compared to patients diagnosed with a nonhematological malignancy. CONCLUSIONS: Nonhematological malignancies were common but non-Hodgkin lymphoma was more predominant in our cohort. PLHIV from high-income countries were more likely to be diagnosed, indicating a potential underdiagnosis of cancer in low-income settings. |
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Journal |
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Awachana Jiamsakul Mark Polizzotto Stephane Wen-Wei Ku Junko Tanuma Eugenie Hui Romanee Chaiwarith Sasisopin Kiertiburanakul Anchalee Avihingasanon Evy Yunihastuti Nagalingeswaran Kumarasamy Penh Sun Ly Sanjay Pujari Rossana Ditangco Cuong Duy Do Tuti Parwati Merati Pacharee Kantipong Fujie Zhang Kinh Van Nguyen Adeeba Kamarulzaman Jun Yong Choi Benedict L.H. Sim Oon Tek Ng Jeremy Ross Wingwai Wong |
author_facet |
Awachana Jiamsakul Mark Polizzotto Stephane Wen-Wei Ku Junko Tanuma Eugenie Hui Romanee Chaiwarith Sasisopin Kiertiburanakul Anchalee Avihingasanon Evy Yunihastuti Nagalingeswaran Kumarasamy Penh Sun Ly Sanjay Pujari Rossana Ditangco Cuong Duy Do Tuti Parwati Merati Pacharee Kantipong Fujie Zhang Kinh Van Nguyen Adeeba Kamarulzaman Jun Yong Choi Benedict L.H. Sim Oon Tek Ng Jeremy Ross Wingwai Wong |
author_sort |
Awachana Jiamsakul |
title |
Brief Report: Malignancies in Adults Living With HIV in Asia |
title_short |
Brief Report: Malignancies in Adults Living With HIV in Asia |
title_full |
Brief Report: Malignancies in Adults Living With HIV in Asia |
title_fullStr |
Brief Report: Malignancies in Adults Living With HIV in Asia |
title_full_unstemmed |
Brief Report: Malignancies in Adults Living With HIV in Asia |
title_sort |
brief report: malignancies in adults living with hiv in asia |
publishDate |
2019 |
url |
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85061481888&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/63701 |
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1681425944363925504 |